NPIMap

Individual provider Active NPI

Mahelet Thorp

  • Dentist
  • Columbia, SC
National Provider Identifier
1679063937
Registry record updated Mar 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
9267 Issued in SC
Practice address
460 Killian Rd
Columbia, SC 29203-9742
Phone
(803) 814-0102
NPI assigned
May 12, 2018
Last updated
Mar 11, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 11, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 17167 MD
Dentist 122300000X 9267 SC Primary
Student in an Organized Health Care Education/Training Program 390200000X NU

Addresses

Primary practice location

460 Killian Rd
Columbia, SC 29203-9742

Mailing address

1200 Network Centre Dr
Effingham, IL 62401-4602

Other practice location 1

2020 Laurel St
Columbia, SC 29204-1019
Phone (803) 254-4543

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
17167MDMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Dental Professionals of South Carolina, P.C. Past Accepting new patients
Steven E Lanham DDS PA Past Accepting new patients
Lifetime Dental Care of Maryland, Badger, P.C. Dentist PastSince Mar 1, 2024 Accepting new patients
Family Dental Center, LLC Past Accepting new patients

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1526083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710115200000",
    "number": "1679063937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 NETWORK CENTRE DR",
            "city": "EFFINGHAM",
            "state": "IL",
            "postal_code": "624014602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "460 KILLIAN RD",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292039742",
            "telephone_number": "803-814-0102"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2020 Laurel St",
            "address_purpose": "LOCATION",
            "city": "Columbia",
            "state": "SC",
            "postal_code": "292041019",
            "country_code": "US",
            "telephone_number": "803-254-4543",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "THORP",
        "first_name": "MAHELET",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-05-12",
        "last_updated": "2024-03-11",
        "certification_date": "2024-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MD",
            "license": "17167",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "SC",
            "license": "9267",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.